Too soon to be concerned?

[rsgdmd]

My profile has background info., but, been getting bloodwork every one to two weeks lately as WBC count hasn't come back to normal since final chemo (Oct 24, 2022) and restarted abiraterone about 6 weeks ago. Since I've been getting CBC and CMP each time, I also get PSA tested.

The past 2 weeks my PSA has gone up a little. Here's the breakdown:

10-24-22 1.069 (last chemo visit)

11-17-22 0.79

12-12-22 0.64

12-29-22 0.49

1-11-23 0.48

1-20-23 0.55

1-27-23 0.59

N.P. says likely normal fluctuation in PSA that wouldn't normally see, but for the frequent testing.

I'll do bloodwork again in 10 - 12 days, but wondering if I'm becoming castrate resistant........

[AlvinSD]

Any lab test is will always have some degree of variability. It is even more apparent at low values like this. Even if you take the same sample and run it 10 or 20 times in a row, you can see variations. I would not worry about a variation like that in a sample that was collected so close in time to your previous sample. Wait more (2-3 months) and do it again and see.

Each vendor of lab equipment and tests has to publish specifications of how much variability is expected when their product is performing normally. We know there is going to be variability in any measurement so statistical data is provided so users understand what “normal” fluctuation is expected. This is referred to as imprecision

(Lab science is what I do professionally and have run many, many PSAs and other tests over the course of my career.)

[billd50]

Looks like you're getting PSAs every 2 weeks or so. As someone already said, there is

variation in the test and you may be within the limits of the accuracy of the testing right

now. I don't think you mentioned if you were on additional treatment like ADT. I'm not

a doc, but I wouldn't stress at this point. Since you just completed chemo, you also need

to give it time to work. It doesn't work instantaneously. Hang in there!

[HopingForTheBest1]

You should not get such frequent PSA testing, as It is not possible to determine any kind of significant trend.

WBC can benefit from being given Neulasta Onpro, which is given right after chemo treatment.

[rsgdmd in reply to HopingForTheBest1]

Unfortunately, Neulasta only brought WBC count up to 3.1 at one week after final chemo. Hasn't been that high since.

[rsgdmd]

So, my PSA is now up to 0.81. Previously

10-24-22 1.069 (last chemo visit)

11-17-22 0.79

12-12-22 0.64

1-11-23 0.48

1-20-23 0.55

1-27-23 0.59

Is PSA doubling an issue if already de novo metastatic? Possible sign that have become castrate resistant?